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1、MusculoskeletalImagingBonelesionsorganizedbycelloforigin Anatomyofthebone BoneLesionsOrganizedbyCellofOrigin p367 Terminology Enostosis boneisland 内生骨疣Osteoma 骨瘤Melorheostosis 肢骨纹状肥大Osteoidosteoma 骨样骨瘤Osteoblastoma 成骨细胞瘤Osteosarcoma 骨肉瘤Synovialchondromatosis osteochondromatosis 滑膜骨软骨瘤Enchondroma 内生软
2、骨瘤Osteochondroma 骨软骨瘤Chondroblastoma 软骨母细胞瘤Chondromyxoidfibroma 软骨黏液样纤维瘤Chondrosarcoma 软骨肉瘤 BoneLesionsOrganizedbyCellofOrigin p367 Terminology Nonssifyingfibroma fibrouscorticaldefect 纤维骨皮质缺损Malignantfibroushistiocytoma 恶性纤维组织细胞瘤Fibrousdysplasia 骨纤维异常增殖症Hemangioma 血管瘤Angiosarcomaofbone 血管肉瘤Giantcel
3、ltumor osteoclastoma 巨细胞瘤Eosinophilicgranuloma langehanscellhistiocytosis 嗜酸性肉芽肿Ewingsarcoma 尤文氏肉瘤Multiplemyeloma plasmacytoma 浆细胞瘤Lymphoma 淋巴瘤Lipoma 脂肪瘤Liposarcoma 脂肪肉瘤 BoneLesionsOrganizedbyCellofOrigin p367 Terminology Chordoma 脊索瘤Simplebonecyst 单纯性骨囊肿Aneurysmalbonecyst 动脉瘤样骨囊肿Adamantinoma 釉质瘤Myo
4、sitisossificans 骨化性肌炎Browntumor 棕色瘤Osteomyelitis 骨髓炎 BoneLesionsOrganizedbyCellofOrigin p367 Contents BoneLesionsOrganizedbyCellofOriginBoneforming Osteo lesionCartilage forming Chondro lesionLesionsoffibrousoriginLesionsofvascularoriginLesionsofhematopoieticoriginFat Lipo lesionsNotochordallesionLe
5、sionsofunknowncelloriginOsseousmetastasisBenigntumormimics BoneLesionsOrganizedbyCellofOrigin p367 1 Boneforming Osteo lesion Benignandincidental Enostosis boneisland 内生骨疣Osteoma骨瘤Melorheostosis肢骨纹状肥大Osteoidosteoma骨样骨瘤Osteoblastoma成骨细胞瘤Malignant Osteosarcoma骨肉瘤 BoneLesionsOrganizedbyCellofOrigin p36
6、7 1 Boneforming Osteo lesion Enostosis boneisland BenignandincidentalfindingAsmallspiculatedosteoblasticfocus小针状成骨细胞聚集Differentiatefromanosteoblasticmetastasis osteoidosteoma oralow gradeosteosarcoma ifthelesson 2cm 成骨性转移 骨样骨瘤或低级别骨肉瘤进行鉴别NormalinbonescanOsteopoikilosisisanautosomaldominantsyndromeofm
7、ultipleboneislandsandkeloidformation全身脆性骨硬化表现为多发骨岛和瘢痕疙瘩 是一种常染色体显性综合征Osteopathiastriataisabenign asymptomaticscleroticdysplasiacharacterizedbylinearbandsofsclerosisinthelongbonesandfan likesclerosisintheflatpelvicbones条纹性骨病是一种良性 无症状性硬化性发育不良 其特征为在长管状骨出现条纹状硬化 骨盆扁平骨呈扇形硬化 BoneLesionsOrganizedbyCellofOrig
8、in p367 1 Boneforming Osteo lesion Osteoma BenignandincidentalAslow growinglesion fromthecortexoftheskullorthefrontal ethmoidsinusesGardnersyndromeisanautosomaldominantsyndromeofmultipleosteomas intestinalpolyposis andsoft tissuedesmoidtumorsGardner综合征是一种常染色体显性综合征 表现为多发骨瘤 肠息肉病和软组织韧带样纤维瘤Incontrasttoa
9、boneisland osteomaarisesfromthecortexratherthanthemedullarycanal相比较于骨岛起源于骨髓腔 骨瘤起源于骨皮质 BoneLesionsOrganizedbyCellofOrigin p367 1 Boneforming Osteo lesion Osteoma Osteoma AxialheadCTinbonewindowshowsadenselyscleroticosteomaarisingfromthecortexofthefrontalsinus BoneLesionsOrganizedbyCellofOrigin p367 1
10、 Boneforming Osteo lesion Melorheostosis Benignandincidental肢骨纹状肥大Non neoplasticproliferationofthickenedandirregularcortexwithatypicalcandle waxappearance非新生物增生改变 表现为骨皮质增厚且不规则 呈蜡泪状改变Pain decreasedrangeofmotion leg bowing leg lengthdiscrepancyAssociatedwithscleroderma likeskinlesionsovertheaffectedre
11、gion肢骨纹状肥大可以伴随硬皮样皮肤病灶 皮肤病灶范围超过骨患病区域Usuallyinasinglelowerlimb inthedistributionofasinglesclerotome Asclerotomerepresentsazonesuppliedbyasinglesensorynerve常见于单侧小腿 分布于单个生骨节 一个生骨节代表单一感觉神经供应的区域Melorheostosisfeaturesintenseuptakeonbonescan BoneLesionsOrganizedbyCellofOrigin p367 Melorheostosis Frontalradi
12、ographoftherighttibiaandfibulashowsthickened irregularwavycortexofthemedialtibia arrow BoneLesionsOrganizedbyCellofOrigin p367 1 Boneforming Osteo lesion Melorheostosis 1 Boneforming Osteo lesion Osteoidosteoma Benign Theetiology Inflammatory vascular andviralcausesTheclassicclinicalpresentation nig
13、htpain relievedbyaspirininateenageroryoungadult11 30岁Location thediaphysesoftheleglongbones femurandtibia mostcommonly theposteriorelementsofthespine about20 最好发于下肢长管状骨骨干 股骨和胫骨 大约20 发生于脊柱后部 脊柱骨样骨瘤是导致疼痛性脊柱侧弯的重要原因 RadiographyandCT alucentnidusissurroundedbysclerosis centralcalcificationwithinthenidus半
14、透明的瘤巢伴周围环绕骨质硬化 瘤巢中央发生钙化Bonescan positive withthedoubledensitysignrepresentingintenseuptakecentrallyintheregionofthenidusandadjacentreactiveuptakecorrespondingtosclerosisMRI thenidusisusuallylow signalonT1WIandreactivemarrowedemacanobscurethelesiononT2WI difficulttodiagnosisinMRI BoneLesionsOrganized
15、byCellofOrigin p367 1 Boneforming Osteo lesion Osteoidosteoma CTshowsaradiolucentnidusintheleftsacralala posteriorelementlocation withalargecentralcalcification yellowarrows withadjacentsclerosis redarrows ThelesionislessconspicuousonMRIandhasverylowsignalontheT1 weightedimage yellowarrow Theposteri
16、orbonescanshowsincreasedradiotraceruptake yellowarrow ofthenidus withadoubledensitysign redarrow correspondingtoreactivesclerosis BoneLesionsOrganizedbyCellofOrigin p367 Benign approximatelyfourtimeslesscommonthanosteoidosteomaHistologicallythesameasanosteoidosteomabutisgreaterthan2cminsize组织学和骨样骨瘤类似 但是成骨细胞瘤大于2cmIntheadolescent youngadultagerangePain nottypicallyrelievedbyaspirinThemostcommonlocation theposteriorelementsofthespine thefemurandtibiaThemostcommonradiographicappearance Lyticlesionwi
